Excavation Permit Utility Installation Permit No. 2023-EP184, UID # 6203
App. Status: Approved
City of Maple Grove
Engineering Department
12800 Arbor Lakes Parkway
Maple Grove, MN 55369

Kelly Matzke (612-968-3615)
 

APPLICANT

Applicant:
Name:
patrick edmonds
Company:
TLR Consulting
Company Phone:Local Phone:
(320963 - 2845
(320963 - 2845
Email Address:
patrick.edmonds-tlr@consulttlr.us
Mailing Address:
9938 state hwy. 55 nw.
annandale mn 55302
Additional email address to notify: patrick.edmonds-tlr@consulttlr.us

CONTRACTOR

Contractor:
Name:
jessub pearson
Company:
MP Nexlevel
Company Phone:Local Phone:
(320963 - 2400
(612499 - 4436
Email Address:
jessub.pearson@mpnexlevel.us
Mailing Address:
500 co. rd. 37 e.
maple lake mn 55358

PROJECT

Nature of Work:
Other
Surface to be disturbed:
Boulevard
Work to start on or after: 07/12/2023
To be completed on or before: 08/10/2023
Applicant Project No.: 21112023E - JB1339209

INSTALLATION / CONSTRUCTION

Provide a detailed work description:
Contractor to set new node pedestal and handhole next to existing power supply. Once completed, contractor to change out existing equipment at locations shown in red on attached map.
Attach detailed plan sheet:
Size and kind of pipe:
2" hdpe
Depth from surface: Other, I will describe below
If other is selected, please provide additional information: 18"
Length of utility construction: 5
Method of installation:
Hand Dig
Open Trench
Development: Existing

LOCATION

Location/Address: 9870 maple grove pkwy.
Mark the location of the installation
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TRAFFIC CONTROL

Will traffic control be necessary? Yes

TRAFFIC CONTROL PLAN

Attach Traffic Control Plan:

Invoice #5703 (05/22/2023)

Charge Cost Quantity Total
Non-Taxable
added 05/22/2023 2:40 PM

Excavation permit fee per occurance

$160.00 x 1 $160.00
added 05/22/2023 2:40 PM

Add obstruction fee if applicable to project.

$50.00 x 1 $50.00
Grand Total
Total $210.00
Payment 05/22/2023$210.00
Due$0.00

SPECIAL PROVISIONS

It is assumed that the proposed work and/or staging will not impact pedestrian traffic along the existing sidewalks/trails. If the proposed work will impact pedestrian traffic, a revised traffic control plan will need to be submitted and approved.

Any proposed work and/or traffic control placed along this segment of Maple Grove Parkway is within County right-of-way, and will also require approval by Hennepin County.

Approvals

ApprovalSignature
ApplicantBen Elsenpeter - 05/22/2023 2:40 PM
a65df35bfe28a075955cfa0c364d88e4
ca7bafe85919a5f563a937cb1b1d0659
#1 Right of Way Technician ApprovalKelly Matzke - 06/01/2023 8:03 AM
1e37d77a9acd63088f074fccaaf14938
7c83d63fb53ee909162c87cc9a6cc1f0
#2 Traffic Operations Engineer ApprovalJohn Hagen - 06/01/2023 10:00 AM
241d2fff599cb4e2b590a09363bb22b0
cfe5f70f61fe9002dfc822d8515aef4d
Application has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

    Internal Notes

    Text:
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